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PURPOSE. To analyze morphologic features of segmental parapapillary diffuse choroidal atrophy (PDCA) in children.

METHODS. The study group included children (age <= 15 years) with high myopia who attended the Tokyo High Myopia Clinic. Control groups comprised participants of the population-based Gobi Desert Children Eye Study (GobiDCES). Fundus photographs were examined for presence of PDCA and choroidal thickness (CT) was measured by optical coherence tomography.

RESULTS. The study group included 41 eyes of 21 children with PDCA (mean age: 9.4 6 3.7 years; mean refractive error: -11.5 +/- 3.1 diopters) and the GobiDCES included 1463 children (age: 11.8 +/- 3.5 years). In the study group, all eyes showed an extreme and abrupt thinning of the temporal parapapillary choroid. At 2500 mu m nasal to the foveola, CT was < 60 mu m in 31 (76%) eyes of the study group but in none (0/1463) of the GobiDCES (P < 0.001), except for one child with PDCA.

CONCLUSIONS. Parapapillary diffuse choroidal atrophy in children is associated with abrupt segmental thinning of the choroid in the temporal parapapillary region, in addition to the thinning of the subfoveal choroid after adjusting for refractive error and age.